This article proposes a tailored approach to reduce antimicrobial use (AMU) in livestock among EU countries, in alignment with the EU Farm-to-Fork initiative that targets a 50 per cent reduction by 2030. We argue against a one-size-fits-all target and introduce country-specific targets based on individual factors such as current antimicrobial sales, GDP, and livestock and human densities. Using data from the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC), the article identifies countries with high densities of animals and humans, as well as high levels of AMU per livestock unit, such as Germany, Belgium, Italy, Spain and Poland, as needing to prioritise greater reduction efforts. The article also underlines the need for a more precise EU-level indicator of AMU, as sales do not directly represent use. It suggests that specific targets and regulations should apply to antimicrobials classified as ‘Highest Priority Critically Important Antimicrobials’ by the WHO. The article recommends extending these targets to different sectors and even individual farms, with high-consumption sectors and poorly performing farms making greater efforts. By considering these factors, the article aims to provide a fair and effective approach to reducing AMU, mitigate the risks associated with antimicrobial resistance, and contribute to achieving the Farm-to-Fork strategy AMU reduction target.
The objective of this study was to analyse and compare the interventions (sets of actions) towards improved antimicrobial use (AMU) in animal production. These were designed in Living Labs (LLs) organised in five countries of the ROADMAP project, with ex ante impact assessment (EAIA) to guide the process. LL participants designed very different types of interventions which targeted systematically farmers and veterinarians but less frequently other stakeholders, despite the ROADMAP ambition to involve the whole value chain in AMU transition scenarios. A variety of factors influenced which interventions were designed, such as the country's AMU levels, existence of AMU monitoring systems, the possibility for veterinarians to profit from antimicrobials sales, export-orientation of the animal production sector and political momentum. Other influential factors included the breadth of desired impacts that the LL participants wished to produce through the interventions they designed (limited to animal health aspects or encompassing other subjects such as animal welfare, consumer information or veterinary business models) and the LL process (choice of participants and facilitators). Overall, the approach succeeded in providing a holistic vision of the possible measures and the obstacles towards improved AMU and produced context-tailored interventions with high acceptability. However, they had limited results in terms of system rethinking.
The reduction of antimicrobial use (AMU) in veterinary medicine is nowadays largely associated with the development of preventive approaches in animal health. This article aims to understand the transformation of veterinarians’ practices, knowledge and working conditions in relation to the promotion of the prudent use of antimicrobials. It analyses the organisational and structural factors that currently favour the development of preventive approaches. The research draws from both a qualitative study and a quantitative survey. The qualitative study sought to understand the views and experiences of veterinarians in different countries. It highlights the difficulties encountered by veterinarians in implementing preventive approaches and promoting prudent AMU. The quantitative survey aimed to understand the variability of veterinarians' attitudes towards AMU and antimicrobial resistance (AMR). It identifies several clusters within the profession, which are distributed differently according to countries, sectors and working conditions, and within which each veterinarian develops different ways of thinking and acting in relation to AMR. We conclude by emphasising the major structural factors that we believe need to be supported to maintain the ongoing transition towards prudent AMU and preventive approaches in animal health. We also suggest different ways of engaging the profession according to the different contexts identified.
La lutte contre la résistance aux antimicrobiens (RAM) s'appuie généralement sur un large ensemble de mesures, telles que l'interdiction ou la restriction de l'utilisation de certaines molécules, la promotion d'approches préventives en santé animale, le contrôle de l'usage et de la prescription des antibiotiques, la formation des éleveurs et des vétérinaires ou encore le développement de démarches qualité et de labels. Ces mesures peuvent être obligatoires (c'est-à-dire des réglementations) ou volontaires (c'est-à-dire des normes privées, des lignes directrices professionnelles, etc.), selon le style d'action publique adopté dans chaque pays: imposer le même cadre d'action pour tout le monde ou tenter de stimuler les initiatives des parties prenantes. Il est cependant difficile de dire qu'une option est meilleure qu'une autre car la réduction de l'utilisation des antimicrobiens dans l’élevage a été obtenue dans différents pays européens en utilisant différentes options. Fondé sur une réflexion croisée de trois études de cas du projet ROADMAP, ce Point de Vue soutient qu'une politique de RAM efficace et légitime doit adopter une combinaison de mesures volontaires et obligatoires soigneusement réfléchies et adaptées aux contextes et dynamiques locaux.
Die Bekämpfung antimikrobieller Resistenzen (AMR) umfasst in der Regel eine Reihe an Maßnahmen, wie das Verbot oder die Einschränkung der Verwendung bestimmter Moleküle, die Förderung präventiver Ansätze im Bereich der Tiergesundheit, das Monitoring des Antibiotikaeinsatzes und -verschreibungen, die Schulung von Landwirten/−innen und Tierärzten/−innen sowie die Entwicklung von Qualitätssystemen und -kennzeichnungen. Diese Maßnahmen können verpflichtend (d. h. Vorschriften) oder freiwillig (d. h. private Standards, Berufsrichtlinien etc.) sein, je nachdem, welcher Politikstil in den einzelnen Ländern verfolgt wird: die Auferlegung eines gleichen Handlungsrahmens für alle oder der Versuch, die Initiativen der Interessengruppen zu fördern. Es ist jedoch schwierig zu sagen, dass eine Option besser als eine andere ist, da ein Rückgang im Einsatz antimikrobieller Mittel in der Tierhaltung in verschiedenen europäischen Ländern mittels unterschiedlicher Optionen erreicht wurde. Anhand einer Querschnittsbetrachtung dreier ROADMAP-Fallstudien wird in diesem Point de Vue argumentiert, dass eine effiziente und legitime AMR-Politik eine Kombination aus freiwilligen und verpflichtenden Maßnahmen erfordert, die sorgfältig durchdacht und an die lokalen Gegebenheiten und Dynamiken angepasst ist.
The urgency to reduce the use of antimicrobials in the livestock sector has become part of the European Farm-to-Fork agenda. To develop innovations and pave the way for prudent antimicrobial use (AMU), the H2020 four-year-long ROADMAP project implemented the approach of Living Labs (LL). It stands for a process that involves a heterogeneous group of stakeholders in co-creation, testing and evaluating innovations in real-world contexts. The use of LLs has gained momentum to accelerate transformation of European agriculture by developing innovations through end-user (farmer) involvement. However, the LL-approach is new in the livestock sector. During the project, 11 LLs were established in seven European countries, each with its own settings but linked to the project's overarching goals. Some LLs developed a common understanding of AMU within the sector or between farmers and veterinarians, while others focussed on policy development or better management practices. During the ROADMAP project, we learned about the potential and limitations of the LL approach in the livestock sector. Using the approach of social innovations, we developed recommendations on how to realise the potential of LLs in a research context to meet the goals of the EU Farm-to-Fork strategy of prudent AMU.
Les diverses politiques et initiatives visant à réduire l'utilisation des antimicrobiens dans la production animale en Europe au cours des dix dernières années ont été couronnées de succès. Dans de nombreux pays, les objectifs de réduction ont été atteints (une réduction des ventes d'antimicrobiens comprise entre 30 et 50 %). Mais lorsqu'il s'agit d'objectifs à plus grande échelle ou à plus long terme, notamment ceux visant à passer à une agriculture plus durable ou plus résiliente, le tableau est beaucoup moins clair. Le succès de la lutte contre la résistance aux antimicrobiens (RAM) ne doit pas masquer le fait qu’à ce jour, peu de progrès ont été réalisés sur les questions de transition. Les formes intensives et industrielles de production animale sont maintenues et parfois renforcées par les stratégies développées pour réduire l'utilisation des antimicrobiens. La réduction et le remplacement des antimicrobiens ont constitué une étape importante, mais la réflexion n'a pas été liée à la remise en cause du système de production, comme le suggéraient en premier lieu les politiques européennes. Il est désormais essentiel de lier les efforts actuels à des changements de grande envergure et à des innovations de rupture. La RAM est un problème parmi tant d'autres. Tous doivent être abordés globalement grâce à une transition vers des formes d'agriculture moins intensives, moins industrielles et plus soucieuses de leur impact sur la santé, l'environnement et la société.
Die verschiedenen politischen Maßnahmen und Initiativen der letzten zehn Jahre zur Verringerung des Einsatzes antimikrobieller Mittel in der europäischen Tierhaltung waren erfolgreich. In vielen Ländern wurden die Reduktionsziele erreicht (Rückgang der Verkäufe antimikrobieller Mittel um 30-50 %). Geht es jedoch um größere oder längerfristige Ziele, nämlich die Umstellung auf eine nachhaltigere oder widerstandsfähigere Landwirtschaft, ist die Situation weit weniger eindeutig. Der Erfolg im Kampf gegen antimikrobielle Resistenzen (AMR) darf nicht darüber hinwegtäuschen, dass bei der Umstellungsthematik bisher kaum Fortschritte erzielt wurden. Intensive und industrielle Formen der Tierhaltung werden durch die Strategien, die zur Verringerung des Einsatzes antimikrobieller Mittel entwickelt wurden, aufrechterhalten und manchmal sogar verstärkt. Die Reduzierung und Substitution antimikrobieller Mittel waren ein wichtiger Schritt, aber diese Überlegungen wurden nicht mit dem Überdenken des Produktionssystems verknüpft, wie es die europäische Politik ursprünglich vorgeschlagen hatte. Es ist jetzt entscheidend, die derzeitigen Bestrebungen mit weitreichenden Veränderungen und bahnbrechenden Innovationen zu verbinden. AMR ist ein Problem von vielen anderen. Sie müssen weltweit angegangen werden, und zwar durch die Umstellung zu einer weniger intensiven, weniger industriellen und stärker auf ihre Auswirkungen auf Gesundheit, Umwelt und Gesellschaft bedachten Landwirtschaft.
The intensification of livestock farming reshaped the epidemiological, economic and environmental landscape of production systems. With the resulting increase in disease pressure, farmers turned to readily available and cost-efficient tools to help manage animal health and even increase productivity – antimicrobials. Growing concerns around antimicrobial resistance (AMR) have prompted regulatory and private initiatives to curtail antimicrobial use (AMU) in livestock. The latter indicates that farmers/livestock industry are taking some ownership of the problem and playing a key role in the solution. In fact, recent research has found that farmers are willing to adjust farming practices if this does not affect financial viability of their businesses. However, our scoping literature review found that information is lacking or insufficient for farmers to make these decisions. It is also vital to understand the extent to which farm-level decisions are producing negative externalities, and what needs to be changed to ensure societal optimum. While advocating for a sustainable reduction in AMU in livestock production, it is important to provide adequate information on the alternatives to their application in managing animal health and welfare. Evidence on the economic, productive and/or epidemiological benefits of such alternatives, when compared to the current situation, are crucial if farmers are to change their production practices with regards to AMU.
As part of the transition to more sustainable agriculture, it has been observed that changes leading to low-to-moderate sustainability, including optimisation and substitution of production processes, are often preferred to more radical changes leading to deep sustainability, i.e. redesigning production processes. In this light, we sought to explore whether this was also the case for antimicrobial use in farm animal production, which has changed over the past decade in an effort to decrease the prevalence of antimicrobial resistance in humans and animals. To explore this, a qualitative approach was used to 1) identify interventions in 12 animal production sectors across 9 European countries, 2) characterise them, and 3) estimate their potential to contribute to the ‘reduce’, ‘replace’ and ‘rethink’ approaches by stimulating the adoption of behaviours related to these strategies. Our findings revealed that while some interventions were identified to potentially contribute solely to one or two of the approaches, the majority were deemed capable of contributing to all three. However, for these interventions, our data suggest that their actual impact, as implemented, was confined to the ‘reduce’ and ‘replace’ approaches, an observation for which we put forward several hypotheses. In addition, policy implications are drawn.
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